BY ALEXIS KACZYNSKI
Gov. Snyder’s upbeat message on the 2015 budget left out an important fact: that in a time of state revenue surplus, about $180 million in state general funds are being removed from community mental health programs in Michigan. The reason for this is simple. Optimism about coverage under Healthy Michigan (Medicaid expansion) has led the administration to assume that mental health clients currently being served with general fund dollars will be eligible for expanded Medicaid. But it is not at all clear this is true, and without thoughtful implementation of this new benefit, many Michigan residents could be left without coverage.
The Problem: Enrollment in the Healthy Michigan program will take months to “ramp up” to the estimated 400,000 persons projected as eligible, and it’s starting late — April 1, not Jan. 1. Money must be available to support services provided to these people until their Medicaid is effective.
Second, some uninsured and needy people still will not qualify for Medicaid, even with revised eligibility criteria. Changes made to the federal program by the state may make the program less attractive or simply impossible to qualify for.
Third, the estimates of resources still needed by community mental health programs after the implementation of Healthy Michigan were too low. Between emergency services, state and community psychiatric hospitalization for the uninsured, support for persons with Medicare and those in spend-down, the obligations are many and they are expensive. These will not go away even if every eligible person applies for Healthy Michigan and is successful in his application.
Public mental health agencies were enthusiastic supporters of Healthy Michigan, and lobbied hard for its passage. It is a necessary and important program for poor people in Michigan. But it is not right to claim state savings by reducing support for community mental health programs, especially until it is clear what enrollment will be. At North Country Community Mental Health, one out of every two persons who applies for services does not have Medicaid. Some are served, but many are turned away, and that is with today’s resources. Many more would remain unserved with the proposed 65 percent reduction in state funding, and that would indeed be a tragedy.